Indwara Y'Amatwi (Amatwi Hagati)

Ikibazo cy'amatwi (rimwe na rimwe bita otite ya gikondo) ni ubwandu bw'amatwi yo hagati, umwanya wuzuye umwuka uri inyuma y'uruhande rw'amatwi rukubiyemo amagufwa mato atotoza amatwi. Abana bafite ibyago byinshi byo kwandura indwara z'amatwi kurusha abakuze.

Ukwangira kw'ibimenyetso n'ibibonwa by'ubwandu bw'amatwi akenshi biba byihuse.

Ibimenyetso n'ibibonwa by'ubwandu bw'amatwi bishobora kwerekana uburwayi butandukanye. Ni ngombwa kubona ubuvuzi nyakuri kandi vuba. Hamagara muganga w'umwana wawe niba:

• Ibimenyetso bikomeje iminsi isaga umwe
• Ibimenyetso biri mu mwana uri munsi y'amezi atandatu
• Kubabara amatwi bikabije
• Umwana wawe utaramenya kugenda cyangwa ukiri muto atabona ijoro ryiza cyangwa arakaye nyuma y'impiswi cyangwa izindi ndwara z'ubuhumekero bw'imbere
• Ubona amazi, ibyuya cyangwa amaraso ava mu gutwi

Ikibazo cy'amatwi giterwa na virusi cyangwa bagiteri mu gice cy'amatwi cyo hagati. Iyi ndwara ikunze kuba ingaruka y'izindi ndwara nk'umwijima, grippe cyangwa agakoko gatera allergie, itera ibicurane n'ububare mu mazuru, mu muhogo no mu myanya ya Eustache.

Ibintu byongera ibyago byo kwandura mu matwi birimo:

• Imyaka. Abana bari hagati y'amezi 6 n'imyaka 2 barashobora kurwara indwara z'amatwi kurusha abandi kubera ubunini n'uburyo bwa tube ya Eustache ndetse n'uko ubudahangarwa bwabo bugikura.
• Kwitabwaho n'itsinda ry'abana. Abana bitabwaho mu matsinda bafite ibyago byinshi byo kurwara ibicurane n'indwara z'amatwi kurusha abana baba mu rugo. Abana baba mu matsinda bahura n'indwara nyinshi, nka grippe.
• Ibyo umwana anywa. Abana banywa mu gikombe, cyane cyane baryamye, bafite ibyago byinshi byo kurwara indwara z'amatwi kurusha abana banywa amata ya nyina.
• Ibihe by'umwaka. Indwara z'amatwi zikunze kugaragara cyane mu gihe cy'igwa n'ubukonje. Abantu bafite allergie z'ibihe bashobora kugira ibyago byinshi byo kurwara indwara z'amatwi igihe umubare w'ibitaka by'ibimera ari mwinshi.
• Imyuka mibi. Kwinjira mu mwuka w'itabi cyangwa umwuka mubi cyane bishobora kongera ibyago byo kurwara indwara z'amatwi.
• Umuco w'abatuye Alaska. Indwara z'amatwi zikunze kugaragara cyane mu baturage ba Alaska.
• Umuhogo watandukanye. Itandukaniro mu gitungo cy'amagufwa n'imitsi mu bana bafite umuhogo watandukanye bishobora gutuma bibagora ko tube ya Eustache isohora ibyuya.

Ubwandu bwinshi bw'amatwi ntibutera ingaruka z'igihe kirekire. Ubwandu bw'amatwi buhora busubira burashobora gutera ingaruka zikomeye:

• Kubura kumva. Kugabanuka gato kumva kuza no kugenda ni bimenyerewe cyane iyo umuntu afite ubwandu bw'amatwi, ariko bisanzwe bikira iyo ubwandu bumaze gukira. Ubwandu bw'amatwi buhora busubira, cyangwa amazi mu matwi yo hagati, bishobora gutera igihombo gikomeye cyo kumva. Niba hari ikintu cyangiritse burundu ku gipande cy'amatwi cyangwa izindi nzego z'amatwi yo hagati, igihombo cyo kumva kiramba gishobora kubaho.
• Ubusembwa bw'imvugo cyangwa iterambere. Niba kumva byangiritse by'igihe gito cyangwa igihe kirekire mu bana bato n'abana bato, bashobora kugira ubusembwa mu kuvuga, mu mibanire no mu iterambere.
• Kwambuka kw'ubwandu. Ubwandu butabonye ubuvuzi cyangwa ubwandu budakira neza ubuvuzi bushobora kwambuka mu tumanuka turi hafi. Ubwandu bw'amagufwa y'umutwe, umunani uri inyuma y'amatwi, bwitwa mastoidite. Ubwo bwandu bushobora gutera iyangirika ry'igufwa no gukora imyanya yuzuye ibyuya. Gake, ubwandu bukomeye bw'amatwi yo hagati burashobora kwambuka mu bindi bice by'umutwe, harimo ubwonko cyangwa imikanda ikingira ubwonko (meningite).
• Gusambura kw'igipande cy'amatwi. Ibipapuro byinshi by'amatwi bikira mu masaha 72. Mu bindi bihe, kuvura imiti ni ngombwa.

Inama zikurikira zishobora kugabanya ibyago byo kwandura indwara z'amatwi:

• Kwirinda ibicurane bisanzwe n'izindi ndwara. Bigisha abana bawe gukaraba intoki kenshi kandi neza, no kudakoresha ibikoresho byo kurya no kunywa kimwe. Bigisha abana bawe guhisha igihuha cyangwa inkorora mu kuboko kwabo. Niba bishoboka, komereza igihe umwana wawe amara mu kigo cyita ku bana. Ikigo cyita ku bana bafite abana bake gishobora gufasha. Gerageza gutuma umwana wawe ataza mu kigo cyita ku bana cyangwa ku ishuri iyo arwaye.
• Kwirinda itabi rya kabiri. Kora uburyo nta muntu na umwe ukora itabi mu rugo rwawe. Hanze y'urugo, jya ahantu hatarimo itabi.
• Konsa umwana wawe. Niba bishoboka, konsa umwana wawe byibuze amezi atandatu. Amata ya nyina afite imiti igabanya ubukana ishobora kurinda indwara z'amatwi.
• Niba utanga amata mu icupa, komeza umwana wawe ahagaze. Irinde gushyira icupa mu kanwa k'umwana wawe ari kuryama. Ntujyane amacupa mu buriri hamwe n'umwana wawe.
• Ganira na muganga wawe ku birebana n'inkingo. Baza muganga wawe ku nkingo zikwiriye umwana wawe. Inkingo za grippe y'ibihe, inkingo za pneumococcal n'izindi nkingo z'ibinyabuzima byangiza zishobora gufasha mu kwirinda indwara z'amatwi.

Umuganga wawe ashobora kumenya indwara y'amatwi cyangwa indi ndwara bitewe n'ibimenyetso ubivuga no kugenzura. Umuganga ashobora gukoresha igikoresho cy'urumuri (otoscope) kugirango arebe amatwi, umuhogo n'umuhogo. Nawe cyangwa we ashobora no kumva umwana wawe akoresheje stethoscope.

Igikoresho cyitwa pneumatic otoscope ni cyo gikoresho gisanzwe umuganga akenera kugirango amenye indwara y'amatwi. Iki gikoresho gifasha umuganga kureba mu gitwi no gusesengura niba hari amazi inyuma y'igitwi. Umuganga akoresheje pneumatic otoscope, ahuha umwuka mu gitwi. Ibirambuye, iyo mwuka yahuje igitwi kigenda. Iyo amatwi yo hagati yuzuye amazi, umuganga azabona ko igitwi ntacyo gikora.

Umuganga wawe ashobora gukora izindi ngero niba hari amakenga ku bihereranye no kumenya indwara, niba indwara itigeze ihinduka bitewe n'ubuvuzi bwabanje, cyangwa niba hari izindi ngero zirebana n'igihe kirekire cyangwa ibibazo by'ingiro.

• Tympanometry. Iyi ngero igereranya uko igitwi gihindagurika. Icyuma, gifunga umuhogo w'igitwi, gihindura imyuka mu muhogo, bigatuma igitwi gihindagurika. Icyuma kigereranya uko igitwi gihindagurika neza kandi kitera imbere igipimo cy'imbaraga mu matwi yo hagati.

• Acoustic reflectometry. Iyi ngero igereranya umusemburo w'amajwi ugaruka uva mu gitwi — igipimo cy'imbaraga cy'amazi mu matwi yo hagati. Ibirambuye, igitwi gikuraho byinshi by'amajwi. Ariko, iyo hari imbaraga z'amazi mu matwi yo hagati, igitwi kizagarura amajwi menshi.

• Tympanocentesis. Rimwe na rimwe, umuganga ashobora gukoresha umugozi muto utwara igitwi kugirango akure amazi mu matwi yo hagati — icyitwa tympanocentesis. Amazi aragenzurwa kugirango abone virusi na bacteria. Ibi bishobora gufasha niba indwara itigeze ihinduka bitewe n'ubuvuzi bwabanje.

• Izindi ngero. Niba umwana wawe yari afite indwara y'amatwi nyinshi cyangwa amazi y'amatwi yo hagati, umuganga wawe ashobora kuguhereza ku mugenzi w'umwuga w'umutwe (audiologist), umuganga w'amajwi cyangwa umuganga w'iterambere kugirango agenzure amatwi, ubushobozi bwo kuvuga, ubushobozi bwo kumva ururimi cyangwa ubushobozi bwo kugenda.

• Acute otitis media. Icyo kumenya "indwara y'amatwi" ni icyo gisanzwe cyitwa acute otitis media. Umuganga wawe ashobora kumenya iyi ndwara niba abona ibimenyetso by'amazi mu matwi yo hagati, niba hari ibimenyetso cyangwa ibimenyetso by'indwara, kandi niba ibimenyetso byatangiye vuba.

• Otitis media with effusion. Niba icyo kumenya ni otitis media with effusion, umuganga yabonye ibimenyetso by'amazi mu matwi yo hagati, ariko ubu ntacyo biriho ibimenyetso cyangwa ibimenyetso by'indwara.

• Chronic suppurative otitis media. Niba umuganga amenya chronic suppurative otitis media, yabonye ko indwara y'amatwi y'igihe kirekire yatumye igitwi kigenda. Ibi birambuye bihuza n'uburo buva mu gitwi.

Ubwandu bumwe bw'amatwi burangira nta miti y'antibiyotike ikoreshwa. Icyiza ku mwana wawe biterwa n'ibintu byinshi, birimo imyaka y'umwana wawe n'uburemere bw'ibimenyetso.

Ibimenyetso by'ubwandu bw'amatwi bisanzwe bigenda bigabanuka mu minsi ibiri ya mbere, kandi ubwandu bwinshi burakira ubwabwo mu cyumweru kimwe cyangwa bibiri nta kuvurwa. Ikigo cy'Abanyamerika cyita ku bana n'Ikigo cy'Abanyamerika cyita ku buvuzi bw'umuryango byemeza ko gutegereza no kureba ari kimwe mu bisubizo byiza kuri:

Hari ibimenyetso bigaragaza ko kuvurwa kwa antibiyotike bishobora gufasha abana bamwe bafite ubwandu bw'amatwi. Ku rundi ruhande, gukoresha antibiyotike kenshi bishobora gutuma bagiteri zihangana n'imiti. Ganira na muganga wawe ku nyungu zishoboka n'ingaruka zo gukoresha antibiyotike.

Muganga wawe azakugira inama ku buryo bwo kugabanya ububabare buterwa n'ubwandu bw'amatwi. Ibi bishobora kuba birimo ibi bikurikira:

Nyuma y'igihe cyo kugenzura, muganga wawe ashobora kugutegeka kuvurwa kwa antibiyotike ku bw'ubwandu bw'amatwi mu bihe bikurikira:

Abana bari munsi y'amezi atandatu bafite otite ya gikondo igaragara neza bafite ibyago byinshi byo kuvurwa n'antibiyotike hatabanje gutegereza.

Ndetse n'inyuma y'aho ibimenyetso bigabanutse, komeza gukoresha antibiyotike nk'uko byategetswe. Kudakoresha imiti yose bishobora gutuma ubwandu busubira kandi bagiteri zihangana n'imiti ya antibiyotike. Ganira na muganga wawe cyangwa umuganga w'imiti ku cyo wakora niba utinze gufata umuti.

Niba umwana wawe afite uburwayi bumwe na bumwe, muganga w'umwana wawe ashobora kugutegeka kubaga kugira ngo amazi ava mu gutwi rwagati. Niba umwana wawe afite ubwandu bw'amatwi busubira kenshi (otite ya gikondo) cyangwa amazi akomeza kuzura mu gutwi nyuma y'aho ubwandu bukikijwe (otite ya gikondo ifite amazi), muganga w'umwana wawe ashobora kugutegeka kubaga.

Mu gihe cy'ubuganga bwo hanze y'ibitaro bita myringotomy, umuganga akora umwobo muto mu gice cy'amatwi cyamutse, bikamworohereza gukurura amazi ava mu gutwi rwagati. Umuyoboro muto (umuyoboro wa tympanostomy) ushyirwa mu mwobo kugira ngo ufashe mu guhumeka gutwi rwagati no gukumira amazi menshi. Imigozi imwe igomba gukomeza gukoreshwa mu mezi ane kugeza kuri 18 hanyuma ikavaho ubwayo. Ibindi bigomba gukomeza gukoreshwa igihe kirekire kandi bishobora gukurwaho hakoreshejwe ubuvuzi.

Igice cy'amatwi gisanzwe gisubiraho nyuma y'aho umuyoboro uvuyeho cyangwa ukurwaho.

Imihogo y'amatwi (imihogo ya tympanostomy, imihogo yo guhumeka, imihogo yo kwishyira mu mwanya) ni imiyoboro mito, isanzwe ikorwa muri pulasitike cyangwa umuringa, ishyirwa mu gice cy'amatwi hakoreshejwe ubuvuzi. Umuyoboro w'amatwi ukorana umwuka uhumeka gutwi rwagati kandi ukabuza amazi gukusanyiriza inyuma y'igice cy'amatwi.

Ubwandu buhoraho butera umwobo cyangwa umwenda mu gice cy'amatwi - bita otite ya gikondo ikomeye - biragoye kuvura. Akenshi bivurwa hakoreshejwe antibiyotike zishyirwa mu matwi. Ushobora kubona amabwiriza yuko wakura amazi anyuze mu muyoboro w'amatwi mbere yo gushyiramo imiti.

Abana bafite ubwandu buhoraho cyangwa bafite amazi ahora mu gutwi rwagati bagomba gukurikiranwa hafi. Ganira na muganga wawe ku kenshi ukwiye gushyiraho gahunda yo gukurikirana. Muganga wawe ashobora kugutegeka gupima amatwi n'ururimi buri gihe.

• Abana bafite amezi 6 kugeza kuri 23 bafite ububabare buke mu gutwi rwagati mu gutwi rimwe igihe kitageze ku masaha 48 kandi bafite ubushyuhe buri munsi ya 102.2 F (39 C)

• Abana bafite imyaka 24 n'irenga bafite ububabare buke mu gutwi rwagati mu gutwi rimwe cyangwa mu byombi igihe kitageze ku masaha 48 kandi bafite ubushyuhe buri munsi ya 102.2 F (39 C)

• Imiti igabanya ububabare. Muganga wawe ashobora kugutegeka gukoresha acetaminophen (Tylenol, izindi) cyangwa ibuprofen (Advil, Motrin IB, izindi) kugira ngo ugabanye ububabare. Koresha imiti nk'uko byanditswe ku kimenyetso. Kora ubwenge mugihe utanga aspirine ku bana cyangwa ku rubyiruko. Abana n'urubyiruko barwaye imitezi cyangwa ibimenyetso nk'iby'igicurane ntibagomba gufata aspirine kuko aspirine ifitanye isano na Reye's syndrome. Ganira na muganga wawe niba ufite impungenge.

• Imiti ibitera uburibwe. Ibi bishobora gukoreshwa kugira ngo bigabanye ububabare niba igice cy'amatwi kitagira umwobo cyangwa umwenda.

• Abana bafite amezi 6 n'irenga bafite ububabare bukabije mu gutwi rimwe cyangwa mu byombi igihe kirenga amasaha 48 cyangwa bafite ubushyuhe bwa 102.2 F (39 C) cyangwa hejuru

• Abana bafite amezi 6 kugeza kuri 23 bafite ububabare buke mu gutwi rwagati mu gutwi rimwe cyangwa mu byombi igihe kitageze ku masaha 48 kandi bafite ubushyuhe buri munsi ya 102.2 F (39 C)

• Abana bafite imyaka 24 n'irenga bafite ububabare buke mu gutwi rwagati mu gutwi rimwe cyangwa mu byombi igihe kitageze ku masaha 48 kandi bafite ubushyuhe buri munsi ya 102.2 F (39 C)